| NPI | 1902174857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: CT 003706) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: CT 189888) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |